A window cleaner died from a blood clot seven weeks after he fell from his ladder and broke both ankles, an inquest has heard.

The sitting at Mays Chambers in Belfast also heard how Brian Cairns had complained about a shortness of breath and back pain in the week prior to his death, but had not sought medical help.

"I asked him if I should get the doctor but he said 'no'. He wasn't one for fuss," his widow Julianne told the court yesterday.

Mr Cairns, a 42-year-old father-of-two from Carn Drive in Newtownabbey, fell about 10ft when his ladder slipped while he was working on November 26, 2008.

Family friend Philip Douglas, who had been with him at the time of the accident, said: "The ladder slipped and he went down. You just knew he had seriously hurt himself ... one of his ankles had completely turned around.

"But he was fit as a fiddle before that happened."

Mr Cairns underwent two operations at the Royal Victoria Hospital before being discharged. He was wheelchair-bound and attended five physiotherapy sessions before his death on January 16, 2009.

According to Sarah Beattie, the lead physio at Musgrave Park Hospital, he had been making good progress towards a full recovery. Ms Beattie told the court if he had indicated that he was suffering from breathlessness her team would have sought assistance from medics.

State Pathologist Jack Crane determined the cause of death as pulmonary embolism due to deep venous thrombosis (DVT), due to bilateral ankle fractures.

The court also heard how the Belfast Trust has reviewed protocol on discharging fracture patients and now prescribes DVT prophylaxis and written information on the risks of pulmonary embolism and thrombosis.

Coroner Brian Sherrard described Mr Cairns' unexpected death as a "terrible loss".

The coroner urged Mrs Cairns to take some comfort from the fact that a change of policy means medical patients will not now find themselves in the same tragic situation as her husband.